Strikes, demonstrations… The negotiations between the liberal doctors and the health insurance ended Thursday, February 23, as they took place, in a tense climate. The goal? Define for the next five years the framework that will govern the links between Social Security and doctors, and in particular the amount of the consultation.
30 €, sous conditions
From the start of negotiations, general practitioners mobilized to demand – among other things – a substantial increase in consultation fees. The majority unions were asking for a change from €25 to €30, while the Doctors for Tomorrow collective went so far as to ask for a doubling of the price. After nearly four months of discussions, the national health insurance fund proposed an increase limited to 1.50 euros per consultation.
This rate may be increased to €30, under certain conditions: the hiring of medical assistants, an increase in the number of patients or regular call duty on Saturday mornings. The director of the national health insurance fund (Cnam) Thomas Fatôme estimates that this device would allow 2 million additional French people to find a doctor, while 6 million of them do not have one.
For medical specialists, the new proposed tariff would amount to €35.
February 28 deadline
For the majority of doctors’ unions, the health insurance proposals are not satisfactory. “The government wants doctors who are committed to taking on more patients and working more, but it has not taken into account the specificities of the profession”, deplores Jérôme Marty, president of the French Union for Free Medicine. (UFML). Health insurance ensures for its part that it would not be a question of “fundamentally working more, but of organizing ourselves differently to meet the needs of the population. »
The unions have until Tuesday, February 28 to accept or not the proposals of Social Security. In the absence of an agreement, the agreement will rely on an arbitration settlement.
The Confederation of French Medical Unions (CSMF) already considers that it will be impossible for it to issue a decision in time. For the union, “the 60% of doctors who do not meet the conditions to obtain a consultation fee of €30 are already angry,” says Luc Duqesnel, president of the CSMF.
Soon the foundations of deconvention
The proposals for the new agreement are not up to par, says the union of General Practitioners France (MG), which accuses the government “of not investing enough to save the health system”. “We are not fighting to have more money in our bank account at the end of the month, but to make the job attractive again and for young people to settle down”, assures Doctor Jean-Christophe Nogrette.
Failing agreement, the Cnam will rely on an arbitrator – in this case Annick Morel, former general inspector of social affairs – who will have three months to write the future agreement. These arbitration rules may be kept for five years, with the obligation to resume negotiations in two years.
Convinced of the endangerment of liberal medicine, the UFML has already announced the holding of “assizes of deconvention” which will take place on March 2 and 3 next.